Provider Demographics
NPI:1134319122
Name:WRATCHFORD, DONA DANIELLE (OD)
Entity Type:Individual
Prefix:
First Name:DONA
Middle Name:DANIELLE
Last Name:WRATCHFORD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 HAMPTON CTR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1708
Mailing Address - Country:US
Mailing Address - Phone:304-598-2020
Mailing Address - Fax:304-598-2024
Practice Address - Street 1:3000 HAMPTON CTR
Practice Address - Street 2:SUITE A
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1708
Practice Address - Country:US
Practice Address - Phone:304-598-2020
Practice Address - Fax:304-598-2024
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2015-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2546152W00000X
WV1084-OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist